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Biomedical subjects

I Vasile

Publications and source records attributed to I Vasile.

44 records · Page 3Linked to original sources

[Clinical and therapeutic considerations on 201 operated hiatal hernias].

A total of 201 patients have been operated over the last 8 years, presenting with hiatal hernias. Five of the patients had para-oesophagian hiatal hernia while the remaining 196 had hiatal hernias following slippage. Some 107 hernias were isolated, and had a classical etiopathogeny, with gastro-oesophagial reflux in 85% of the cases. Cardio-vascular disturbances and digestive hemorrhage were present in 15% of the cases. In 89 patients the hiatal hernias were associated with various affections in the supra-mesocolic space. There were 54 patients with biliary affections and 35 with piloro-duodenal affections. The indication for operation was established on the basis of clinical symptoms which included gastrooesophagial reflux, radiological signs of the reflux and indirect signs of oesophagitis. The surgical procedures employed were various, and included a personal procedure. The immediate and the late postoperative results were similar to those reported in the specialized literature.

Aged↗

[Acute necrotizing enterocolitis in an adult--a clinical study].

The authors retrospectively reviewed 24 cases of necrotizing enterocolitis, in which the diagnosis was made or confirmed intraoperatively. This article points to the complex pathophysiology and preoperative diagnostic difficulties of necrotizing enterocolitis due to its clinical heterogeneity and lack of specificity of the laboratory findings. Given all these preoperative problems quite too often the best operatory moment is los and despite the somehow simple intraoperative diagnosis and the modern, well established surgical principles: resection of the necrotic segment with secondary reanastomosis (whenever possible), the post-therapeutic mortality rate remains disappointingly high (70.8%).

Abdominal Pain↗

[Plastic repair with Plastex-type synthetic mesh in abdominal wall defects].

This paper analyses a statistical series of 53 patients suffering from single or multiple abdominal wall defects and who were managed by plastic surgery with Plastex type synthetic mesh. Our results are pleading for the extension of the indications of Plastex mesh buttressing surgery beyond the usual recurrent "hernia" cases to the patients admitted with nonrecurrent either large abdominal wall defects or, and poor-quality musculoaponevrotic parietes of the abdominal wall. Our study recorded recurrence and postoperative morbidity rates have been minimal due to both a correct selection of cases for this type of surgical repair and an adequate patient preoperative management in which antibiotic and thromboembolic prophylaxis have been applied on a regular basis.

Abdominal Muscles↗

[Nosocomial infections in the Clinica Chirurgie CFR, Craiova].

The authors present Craiova CFR General Surgery Clinic experience on hospital infections from 1991 through 1996. This study shows that the frequency of hospital infections in our clinic is greater than all the other postoperative complications. Over the investigated period of time we witnessed an increase in the incidence of the postoperative septic complications in addition to those directly linked to the operated interventions (e.g. wound infections, postoperative peritonitis) such as: pulmonary infections: urinary tract infections, catheter sepsis etc. Finally, the authors pointed to the consequences of the hospital infections such as: mortality and late morbidity rates, economic implications. Thus, it is worth mentioning that 30 deaths (75%) out of our clinic total of 40 over the studied period of time were due to a postoperative infections and treatments.

Cross Infection↗

[A plea for the conservative treatment of breast cancer].

This article is a plea for the implementation of early-stage breast cancer conservative therapy into as many surgical clinics as possible. The aforementioned statement relies mainly on published papers and data (the protocol included) provided to us by Instituti Clinici di Perfezionamento di Milano experts in breast cancer conservative therapy and to a lesser extent on our not too numerous results (30 cases) obtained over the past 2 years since we applied the Milano protocol on a regular basis. Thus we support the view that the breast-conserving treatment is suitable for clinical stage I or II carcinoma whose tumors are 3 cm or less in greatest diameter, provided axillary lymphadenectomy is associated for prognostic and future management guidance reasons, but not for cure. Breast-limited postoperative radiation treatment is foremost aimed at local recurrences rate reduction without significantly influencing survival rate. Postoperative chemotherapy, indicated for node-positive patients and/or primary tumors over 1 cm in greatest, diameter, has been proved to contribute to long-term survival rate. However, both the small sample size and the short period of observation of our study prevented us from drawing firm conclusions directly.

Adenocarcinoma↗

[Urinary infections with hospital germs in general surgery].

Nosocomial urinary tract infection is the most common type of sepsis in the post-surgical patient. This paper presents our experience with 218 nosocomial urinary infections (34.93% of our postoperative infections) which complicated the postoperative course of 1002 (21.75%) urethral catheterized patients out of a total of 5950 (3.6%) operated on and under study individuals. Thus we found that urethral catheterization is the most important risk factor for post-surgery urinary infections. Moreover, in our series the postoperative urinary tract sepsis bacteriology is dominated (> 95% of cases) by aerobic gram-negative bacilli that mainly reside in the bowel and also commonly colonize the perineum. Furthermore, we demonstrated that post-surgical urinary infections did not influence directly death rate but they had a significant bearing on care costs. Finally we consider the prevention of postoperative nosocomial urinary tract sepsis as an essential principle of this condition management.

Cross Infection↗